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Özokcu K, Diesveld MME, Gipmans SGH, Peeters LEJ, van den Born BJ, Borgsteede SD. Developing practical recommendations for drug-disease interactions in patients with hypertension. Front Pharmacol 2024; 15:1360146. [PMID: 38694908 PMCID: PMC11061388 DOI: 10.3389/fphar.2024.1360146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/26/2024] [Indexed: 05/04/2024] Open
Abstract
Background Hypertension, a significant risk factor for cardiovascular diseases, demands proactive management as cardiovascular diseases remain the leading cause of death worldwide. Reducing systolic and diastolic blood pressure levels below recommended reference values of <140/90 mmHg can lead to a significant reduction of the risk of CVD and all-cause mortality. However, treatment of hypertension can be difficult and the presence of comorbidities could further complicate this treatment. Drugs used to manage these comorbidities may inadvertently have an impact on blood pressure, resulting in a phenomenon known as drug-disease interaction. This study aims to assess the safety of medication that can affect blood pressure in patients with hypertension and provide practical recommendations for healthcare professionals. Methods For the development of recommendations for the drug-disease interaction (DDSI) hypertension, a six-step plan that combined literature selection and multidisciplinary expert opinion was used. The process involved (1) defining the scope of the DDSI and selecting relevant drugs, (2) collecting evidence, (3) data-extraction, (4) reaching of expert consensus, (5) publication and implementation of the recommendations in healthcare systems and (6) updating the information. Results An increase of 10 mmHg in systolic blood pressure and 5 mmHg in diastolic blood pressure was defined as clinically relevant. Corticosteroids, danazol, and yohimbine caused a clinically relevant DDSI with hypertension. Several other drugs with warnings for hypertension in the official product information were assessed to have no clinically relevant DDSI due to minor influence or lack of data on blood pressure. Drugs with evidence for a relevant change in blood pressure which are prescribed under close monitoring of blood pressure according to clinical guidelines, were deemed to be not clinically relevant for signalling. Conclusion This study provides specific recommendations that can be implemented directly in clinical practice, for example, in clinical decision support systems, potentially resulting in safer drug use in patients with hypertension and better healthcare by reducing alert fatigue. Future research should focus on evaluating the effectiveness of implementation strategies and their impact on reducing unsafe use of medication in patients with hypertension.
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Affiliation(s)
- Kübra Özokcu
- Department of Hospital Pharmacy, Meander Medisch Centrum, Amersfoort, Netherlands
- Department of Hospital Pharmacy, Ziekenhuis Rivierenland, Tiel, Netherlands
| | - Maaike M. E. Diesveld
- Department of Clinical Decision Support, Health Base Foundation, Houten, Netherlands
| | - Suzan G. H. Gipmans
- Medicines Information Centre, Royal Dutch Pharmacists Association (KNMP), The Hague, Netherlands
| | | | - Bert-Jan van den Born
- Departments of Internal Medicine and Public Health Amsterdam Cardiovascular Sciences Amsterdam UMC, Amsterdam, Netherlands
| | - Sander D. Borgsteede
- Department of Clinical Decision Support, Health Base Foundation, Houten, Netherlands
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2
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Coumau C, Gaspar F, Terrier J, Schulthess-Lisibach A, Lutters M, Le Pogam MA, Csajka C. Drug-drug interactions with oral anticoagulants: information consistency assessment of three commonly used online drug interactions databases in Switzerland. Front Pharmacol 2024; 15:1332147. [PMID: 38633615 PMCID: PMC11022661 DOI: 10.3389/fphar.2024.1332147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/15/2024] [Indexed: 04/19/2024] Open
Abstract
Background: Toxicity or treatment failure related to drug-drug interactions (DDIs) are known to significantly affect morbidity and hospitalization rates. Despite the availability of numerous databases for DDIs identification and management, their information often differs. Oral anticoagulants are deemed at risk of DDIs and a leading cause of adverse drug events, most of which being preventable. Although many databases include DDIs involving anticoagulants, none are specialized in them. Aim and method: This study aims to compare the DDIs information content of four direct oral anticoagulants and two vitamin K antagonists in three major DDI databases used in Switzerland: Lexi-Interact, Pharmavista, and MediQ. It evaluates the consistency of DDIs information in terms of differences in severity rating systems, mechanism of interaction, extraction and documentation processes and transparency. Results: This study revealed 2'496 DDIs for the six anticoagulants, with discrepant risk classifications. Only 13.2% of DDIs were common to all three databases. Overall concordance in risk classification (high, moderate, and low risk) was slight (Fleiss' kappa = 0.131), while high-risk DDIs demonstrated a fair agreement (Fleiss' kappa = 0.398). The nature and the mechanism of the DDIs were more consistent across databases. Qualitative assessments highlighted differences in the documentation process and transparency, and similarities for availability of risk classification and references. Discussion: This study highlights the discrepancies between three commonly used DDI databases and the inconsistency in how terminology is standardised and incorporated when classifying these DDIs. It also highlights the need for the creation of specialised tools for anticoagulant-related interactions.
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Affiliation(s)
- Claire Coumau
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Frederic Gaspar
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Jean Terrier
- Division of General Internal Medicine, Geneva University Hospitals, Geneva, Switzerland
- Geneva Platelet Group, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Clinical Pharmacology and Toxicology Division, Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine Department, Geneva University Hospitals, Geneva, Switzerland
| | | | - Monika Lutters
- Clinical Pharmacy, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Marie-Annick Le Pogam
- Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Chantal Csajka
- Centre for Research and Innovation in Clinical Pharmaceutical Sciences, University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Lausanne, Switzerland
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3
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Livingston C, Monroe-Duprey L. A Review of Levodopa Formulations for the Treatment of Parkinson's Disease Available in the United States. J Pharm Pract 2024; 37:485-494. [PMID: 36704966 DOI: 10.1177/08971900221151194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Purpose: The safety and efficacy of levodopa formulations are evaluated to inform clinical decision making for the treatment of Parkinson's disease. Summary: Levodopa is a cornerstone of treatment for Parkinson's disease due to its proven efficacy. Although many patients can initially be managed using immediate release tablets, as their disease progresses they often require escalating doses as well as more frequent dosing to prevent wearing off effects. Additionally, patients who experience time in the off state may struggle with the delay between medication administration and onset of action. Therefore, to increase patient convenience as well as to enhance the pharmacokinetic profile of the levodopa, several other formulations have been developed. Levodopa coformulated with carbidopa is supplied as immediate release tablets, oral disintegrating tablets, controlled release tablets, extended release capsules, and a continuous enteral solution. Additionally, there is a levodopa inhalation powder available. As a result of their different absorption profiles, each formulation has unique safety and efficacy attributes. Consequently, while this expansion of levodopa formulations has substantially increased treatment options for patients, it has also increased the complexity of medical decision making for patients, providers, and health systems alike. Conclusion: Knowledge of the different pharmacokinetic, safety and efficacy profiles of the available levodopa formulations is critical for the effective management of Parkinson's disease on both the individual patient and population levels.
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Affiliation(s)
- Clare Livingston
- Department of Pharmacy, Inova Health System, Alexandria, VA, USA
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4
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Levien TL, Baker DE. Formulary Drug Reviews: Nirsevimab. Hosp Pharm 2024; 59:138-145. [PMID: 38450347 PMCID: PMC10913880 DOI: 10.1177/00185787231212620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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5
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Armstrong Cook J, Pouliot J, Parker R. Out With the Old, in With the New: What Rising Pharmacists Need to Know About Vancomycin Therapeutic Drug Monitoring in Adults. J Pharm Pract 2024; 37:261-264. [PMID: 36607606 DOI: 10.1177/08971900221150321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The goal of this commentary is to provide recent pharmacy school graduates and student pharmacists completing APPEs the essential background for correct vancomycin therapeutic drug monitoring (TDM) in the inpatient setting.
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Affiliation(s)
- Jessica Armstrong Cook
- College of Pharmacy, Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA
| | - Jonathan Pouliot
- College of Pharmacy, Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA
- Department of Pharmacy and Pharmaceutical Sciences, Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA
| | - Robin Parker
- College of Pharmacy, Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA
- Department of Pharmacy and Pharmaceutical Sciences, Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA
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6
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Light J, Ruh C, Ott M, Banker C, Meaney D, Doloresco F, Noyes K. The Effect of Pharmacy-Led Medication Reconciliation on Odds of Psychiatric Relapse at a Community Hospital. J Pharm Pract 2024; 37:391-398. [PMID: 36314582 DOI: 10.1177/08971900221137100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Purpose: Individuals with psychiatric disorders are at increased risk for treatment non-adherence and related complications, especially during transitions of care. Medication reconciliation is now a standard process during hospital admissions that is uniformly recommended by international organizations to aid in safe and effective care transitions. Pharmacy-led medication reconciliation (PMR) practices are poised to represent a standardized method of reconciliation attempt within this underserved population with complex medication histories. Methods: A retrospective cross-sectional study using medical chart review was conducted for all adults admitted to the inpatient psychiatric service at a community hospital in Buffalo, NY, during 2 months in 2018. Outcomes were 30- and 180-day psychiatric readmission rates, 30- and 180-day visit rates to the outpatient comprehensive psychiatric emergency program (CPEP), and composite 30- and 180-day relapse. Receipt of pharmacy-led medication reconciliation was identified from pharmacy documentation in the electronic medical record. Results: 78% of patient's medication lists on admission were reconciled, with 49% of reconciliations made by the inpatient pharmacy. Presence of a PMR did not alter the odds of inpatient readmission alone, however patients without a PMR were found to have 2.13 times higher odds of visiting the hospital's outpatient CPEP within 30-days (P = .012) and 1.9 times higher odds of any composite psychiatric relapse within 30-days (P = .024). Conclusions: Implementation of hospital-wide pharmacy-led medication reconciliation on admission may help reduce psychiatric relapse across multiple care settings.
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Affiliation(s)
- Jamie Light
- Erie County Medical Center, Buffalo, NY, USA
| | | | - Michael Ott
- Erie County Medical Center, Buffalo, NY, USA
| | - Christopher Banker
- University at Buffalo School of Public Health and Health Professions, Buffalo, NY, USA
| | - Drake Meaney
- University at Buffalo School of Public Health and Health Professions, Buffalo, NY, USA
| | - Fred Doloresco
- University at Buffalo School of Public Health and Health Professions, Buffalo, NY, USA
| | - Katia Noyes
- University at Buffalo School of Public Health and Health Professions, Buffalo, NY, USA
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7
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Fazio V, Altshuler J, Song YB. Safety and Feasibility of Opening Tamsulosin Capsules for Enteral Feeding Tube Administration. J Pharm Pract 2024:8971900241233615. [PMID: 38379309 DOI: 10.1177/08971900241233615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Purpose: Tamsulosin is formulated as sustained release beads within a capsule to prevent rapid absorption and associated hypotension. The package insert advises the capsule is swallowed whole; not crushed, chewed, or opened. To our knowledge, there are no current data on opening capsules for adults with enteral tube feeds. Given the unidentified safety and efficacy of administration via enteral tubes, alternative alpha blockers with less selectivity for alpha1A are often used. Methods: A single center retrospective chart review was conducted at two hospital sites. Adult patients that received at least one dose of tamsulosin or doxazosin while an enteral feeding tube was placed were included. Safety outcomes evaluated were the number of documented tube obstructions and incidence of medication associated hypotension. Results: 169 patients were included. Ten enteral feeding tube obstructions were reported, 4 of 110 (3.64%) in the tamsulosin arm and 6 of 59 (10.17%) in the doxazosin arm (RR .36, 95% CI .11 to 1.22, P = .099). At least 1 episode of medication associated hypotension occurred in 22 of 98 (22.45%) in the tamsulosin arm and 20 of 49 (40.82%) in the doxazosin arm (RR .55, 95% CI .33 to .91, P = .019). Conclusion: There was no statistically significant difference in the number of tube obstructions between patients receiving tamsulosin or doxazosin via enteral tube feeds. Patients receiving doxazosin were at increased risk of experiencing medication related hypotension. Tamsulosin capsules may be opened and administered via enteral feeding tubes if administered with content integrity intact.
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Affiliation(s)
- Victoria Fazio
- Pharmacy Department, Hackensack Meridian Health JFK University Medical Center, Edison, NJ, USA
| | - Jerry Altshuler
- Pharmacy Department, Hackensack Meridian Health JFK University Medical Center, Edison, NJ, USA
| | - Yong-Bum Song
- Pharmacy Department, Hackensack Meridian Health JFK University Medical Center, Edison, NJ, USA
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8
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Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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9
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Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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10
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Ingebrigtson M, Miller JT. Adverse Hemodynamic Effects of Dexmedetomidine in Critically Ill Elderly Adults. J Pharm Pract 2023; 36:1319-1323. [PMID: 35730589 DOI: 10.1177/08971900221110159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Dexmedetomidine is a currently recommended first-line sedative agent for critically ill patients requiring mechanical ventilation. Recent trials demonstrated no difference in clinical outcomes between patients treated with dexmedetomidine vs usual care, but significantly more hemodynamic adverse effects in the dexmedetomidine group. One subgroup analysis suggested a 90-day mortality benefit in elderly patients, but no distinction was made between groups regarding age when reporting adverse effects. Given potential decreased baroreceptor function in the elderly, adverse hemodynamic effects of dexmedetomidine may impact them more. Objective: To assess the incidence of adverse hemodynamic effects of dexmedetomidine in elderly ICU patients compared to other sedative agents to clarify the role of dexmedetomidine in this patient population. Methods: This was a single-center, retrospective study including mechanically ventilated elderly patients requiring sedative agents for ≥12 hours. The primary outcome evaluated was composite end point of incidence of bradycardia and hypotension. Secondary outcomes included incidence of each adverse event individually, hospital and ICU length of stay, and duration of mechanical ventilation. Results: There was no difference in adverse events between the two groups (58.7% vs 74.1% in the dexmedetomidine vs usual care groups, P =.074). There was no difference in hospital or ICU length of stay. Patients in the dexmedetomidine group were on the ventilator longer than patients in the usual care group with a median of 6 vs 3 days, respectively (P = 0.004). Conclusion: In this single-center, retrospective study dexmedetomidine had a similar incidence of adverse events in elderly patients compare to the usual care group.
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Affiliation(s)
| | - James T Miller
- Department of Pharmacy Services, Michigan Medicine, Ann Arbor, MI, USA
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11
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Al Zoubi S, Gharaibeh L, Amaireh EA, Khlaifat GS, Khalayla HMD, Obeid SN, Abukhalaf KA, AlSalamat AM, Al-Zoubi Z. Drug information-seeking behaviour among Jordanian physicians: a cross-sectional study. Front Pharmacol 2023; 14:1264794. [PMID: 38026931 PMCID: PMC10679432 DOI: 10.3389/fphar.2023.1264794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
Background: Due to the huge number of drugs available and the rapid growth and change in drug information, healthcare professionals, especially physicians, frequently require reliable, easily accessible, rapid, and accurate reference sources to obtain the necessary drug information. Several sources of information are available for physicians to use and select from; however, the information-seeking behaviour of healthcare providers is varied, and this process can be challenging. Objectives: In this study, Jordanian physicians were approached to evaluate the drug information they require, the sources of information they use, the perceived credibility of the sources, and the challenges they face when searching for the most accurate and current information about drugs. Methods: This is an observational, cross-sectional study. A self-administered questionnaire was distributed to practising physicians in Jordan using a convenience sampling method (purposive sampling followed by snowball sampling) regardless of their speciality, age, gender, seniority, or place of employment. Results: Three hundred and eighty physicians participated in the study. Most participants responded that they performed drug information searches on a weekly (155, 40.8%) or a daily basis (150, 39.5%). The drug-related information that physicians most frequently searched for concerned dosage regimens and adverse drug events. The majority of surveyed doctors (97.9%) reported using online websites to acquire drug information; UpToDate®, Medscape and Drugs.com were the most frequently used online databases, although many participants did not consider online sources to be the most reliable source. The most prevalent and recurrent challenges encountered concerned an inability to access subscription-only journals and websites (56.6%), difficulty identifying trusted and credible sources (41.8%) and the enormous number of available sources (35.3%). However, these challenges were less of a problem for physicians who currently work or have previously worked in academia (p < 0.001). Conclusion: This study demonstrated that Jordanian physicians frequently use online websites to look for drug information and all doctors face challenges throughout this process particularly those with no experience in academia. This suggests that being in academia makes the process of information-seeking easier which highlights the need for academics to transfer their knowledge and experience to their non-academic colleagues and the upcoming generations of physicians.
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Affiliation(s)
- Sura Al Zoubi
- Department of Basic Medical Sciences, School of Medicine, Al-Balqa Applied University, As-Salt, Jordan
| | - Lobna Gharaibeh
- Pharmacological and Diagnostic Research Center, Biopharmaceutics and Clinical Pharmacy Department, Faculty of Pharmacy, Al-Ahliyya Amman University, Amman, Jordan
| | | | | | | | | | | | - Amer M. AlSalamat
- Department of Obstetrics and Gynecology, Jordanian Royal Medical Services, Amman, Jordan
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Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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14
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Elste JM, Ipema HJ, Denton C, Munir F, Alomari R, Dazy A, Macrito R, Szydlowski N. Light-Sensitive Injectable Prescription Drugs-2022. Hosp Pharm 2023; 58:448-475. [PMID: 37711411 PMCID: PMC10498972 DOI: 10.1177/00185787221133804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
This chart is an update to the 2014 article published in Hospital Pharmacy on injectable drugs that require protection from light. To update the chart, an online search of the FDALabel database was performed from inception through July 31, 2022 using the terms "protect" OR "light." After filtering out drugs with non-injectable routes of administration, the list of generic drug names was combined with the 2014 list and duplicates were removed. The resulting list of drugs was then reviewed to determine whether the drugs require protection from light during storage, preparation, or administration. The reader should always consult the Food and Drug Administration-approved prescribing information for the most up-to-date information regarding the need for protection from light.
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Affiliation(s)
- Jessica M. Elste
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Heather J. Ipema
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Christie Denton
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Faria Munir
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Ruba Alomari
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Anna Dazy
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Rosa Macrito
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Nicole Szydlowski
- University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
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Nguyen N, Ayyad A. Vancomycin-Induced Leukopenia and Neutropenia: Time Will Tell. Hosp Pharm 2023; 58:441-443. [PMID: 37711407 PMCID: PMC10498966 DOI: 10.1177/00185787231158775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Purpose: Neutropenia is an uncommon adverse effect associated with prolonged vancomycin therapy. Methods: This was a case report on a 62-year-old African American male with hypertension, paranoid schizophrenia, and a history of polysubstance abuse developed foot osteomyelitis. The patient was initially maintained on intravenous Vancomycin & Ceftriaxone for ~3 weeks but adjusted to Daptomycin & Ceftriaxone while in hospital due to neutropenia. Patient's neutropenia quickly resolved once discontinuation of Vancomycin occurred. Results: Vancomycin is a potential cause of drug induced leukopenia and neutropenia. Monitoring of leukocytes and neutrophils is warranted in patients receiving long term intravenous Vancomycin therapy. Conclusion: Vancomycin is a bactericidal glycopeptide antibiotic with activity against gram-positive organisms such as Staphylococci. Well-known adverse drug events include nephrotoxicity and ototoxicity. Vancomycin-induced neutropenia on the other hand is less common and reported at lower rates. It is defined as an ANC less than 1000 µL in patients maintained on Vancomycin infusions. According to Black et al, neutropenia is more likely associated with prolonged therapy; generally occurring at least 20 days after initiation.
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Affiliation(s)
- Nam Nguyen
- Xavier University of Louisiana College of Pharmacy, New Orleans, LA, USA
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
| | - Ahlam Ayyad
- Xavier University of Louisiana College of Pharmacy, New Orleans, LA, USA
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
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Aloe S, Filliter C, Salmasi S, Igweokpala S, Yu OHY, Tagalakis V, Filion KB. Sodium-glucose cotransporter 2 inhibitors and the risk of venous thromboembolism: A population-based cohort study. Br J Clin Pharmacol 2023; 89:2902-2914. [PMID: 37183930 DOI: 10.1111/bcp.15787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 04/21/2023] [Accepted: 05/05/2023] [Indexed: 05/16/2023] Open
Abstract
AIMS The cardiovascular benefits of sodium-glucose cotransporter 2 inhibitors (SGLT2Is) result from their complex impact on coronary and arterial vessels. However, their effect on veins and the risk of venous thromboembolism (VTE) remains unclear. Meta-analysis of trials has suggested no significant change in risk, but observational studies on the topic are scarce. Our objective was to determine if the use of SGLT2Is, compared to the use of dipeptidyl peptidase 4 inhibitors (DPP-4Is), is associated with the risk of VTE among patients with type 2 diabetes. METHODS Using the Clinical Practice Research Datalink linked to hospitalization and vital statistics databases, we conducted a retrospective cohort study using a prevalent new-user design. SGLT2Is were matched to DPP-4I users on calendar time, diabetes treatment intensity, duration of previous DPP-4I use and time-conditional high-dimensional propensity score. Cox proportional hazard models estimated the hazard ratio (HR) for VTE with SGLT2Is versus DPP-4Is. RESULTS SGLT2I use was not associated with an increased risk of VTE (HR 0.65, 95% confidence interval [CI] 0.34 to 1.25). This finding was consistent among prevalent (HR 0.47, 95% CI 0.16 to 1.42) and incident (HR 0.75, 95% CI 0.33 to 1.72) new users. CONCLUSIONS We found that SGLT2Is were not associated with an increased risk of VTE compared to DPP-4Is. Although we observed a numerically decreased risk of VTE with SGLT2Is, estimates were accompanied by wide 95% CIs. Nonetheless, given the morbidity associated with VTE, our results provide some reassurance regarding the safety of SGLT2Is with respect to VTE.
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Affiliation(s)
- Stephanie Aloe
- Department of Endocrinology & Metabolism, McGill University, Montreal, Quebec, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Christopher Filliter
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Shahrzad Salmasi
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Samuel Igweokpala
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Oriana H Y Yu
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Division of Endocrinology and Metabolism, Jewish General Hospital/McGill University, Montreal, Quebec, Canada
| | - Vicky Tagalakis
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Division of General Internal Medicine, Jewish General Hospital/McGill University, Montreal, Quebec, Canada
| | - Kristian B Filion
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
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17
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Saito R, Miyazaki S. Analysis of safety specifications in risk management plan at the time of drug approval and addition of clinically significant adverse reactions in the package insert post-approval in Japan. Pharmacol Res Perspect 2023; 11:e01110. [PMID: 37365794 DOI: 10.1002/prp2.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/28/2023] Open
Abstract
Recently, post-marketing safety measures have been considered critical in Japan due to the globalization of drug development and the introduction of new drug approval systems. Pharmacists are expected to play an active role in ensuring the safety of drugs post-approval. Utilizing risk management plans (RMPs) to ensure safety throughout the development and post-marketing phases is becoming even more critical. In this study, we examine the relationship between the safety specifications (SSs) in RMPs at the time of drug approval and the adverse reactions (ARs) added to the clinically significant adverse reactions (CSARs) section of the package inserts (PIs) post-approval to determine whether SSs constitute useful drug information for pharmacists. The analysis included new active ingredient-containing drugs approved in Japan from FY2013 to 2019. A 2 × 2 contingency table was created and analyzed using odds ratios (ORs) and Fisher's exact test. The OR was 14.22 (95% CI: 7.85-24.77; p < .001), which indicates a strong relationship between the ARs being SSs at the time of approval and being added to the PIs as CSARs post-approval. The positive predictive value that SSs at the time of approval were added as CSARs to the PIs post-approval was 7.1%. In addition, a similar relationship was observed with the "approval in shorter-period drugs" reviewed for approval based on a limited number of clinical trials. Therefore, SSs in RMPs are important drug information for pharmacists in Japan.
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Affiliation(s)
- Rieko Saito
- Division of Social Pharmacy and Regulatory Science, Showa Pharmaceutical University, Machida-shi, Tokyo, Japan
| | - Seiko Miyazaki
- Division of Social Pharmacy and Regulatory Science, Showa Pharmaceutical University, Machida-shi, Tokyo, Japan
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18
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Keats KR, Robinson R, Patel M, Wallace A, Albrecht S. Ascorbic Acid for Methemoglobinemia Treatment: A Case Report and Literature Review. J Pharm Pract 2023:8971900231188834. [PMID: 37421600 DOI: 10.1177/08971900231188834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
PURPOSE Ascorbic acid has been proposed as an alternative treatment for methemoglobinemia in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. However, its efficacy has never been compared to that of methylene blue given the inability of patients with G6PD deficiency to receive methylene blue. We present a case of methemoglobinemia treated with ascorbic acid in a patient without G6PD deficiency who had previously received methylene blue. SUMMARY A 66-year-old male was treated for methemoglobinemia deemed to be secondary to benzocaine throat spray. He received intravenous (IV) methylene blue but had a severe reaction: diaphoresis, lightheadedness, and hypotension. The infusion was stopped prior to completion. Approximately 6 days later he presented with methemoglobinemia following an additional overconsumption of benzocaine and was treated with ascorbic acid. In both instances his methemoglobin levels were >30% on arterial blood gas on admission and decreased to 6.5% and 7.8%, respectively, after administration of methylene blue and ascorbic acid. CONCLUSION Ascorbic acid had a similar effect on decreasing the concentration of methemoglobin compared to methylene blue. Further research into use of ascorbic acid as a recommended agent for treatment of methemoglobinemia is warranted.
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Affiliation(s)
- Kelli R Keats
- Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA
| | - Rachel Robinson
- Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA
| | - Mallika Patel
- Department of Internal Medicine, Augusta University Medical Center, Augusta, GA, USA
| | - Alexis Wallace
- Department of Internal Medicine, Augusta University Medical Center, Augusta, GA, USA
| | - Stephanie Albrecht
- Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA
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19
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Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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20
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Shaniv D, Bolisetty S, Young TE, Mangum B, Ainsworth S, Elbers L, Schultz P, Cucchi M, de Wildt SN, van der Zanden TM, Caldwell N, Smits A, Allegaert K. Neonatal Drug Formularies-A Global Scope. Children (Basel) 2023; 10:children10050848. [PMID: 37238396 DOI: 10.3390/children10050848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
Neonatal drug information (DI) is essential for safe and effective pharmacotherapy in (pre)term neonates. Such information is usually absent from drug labels, making formularies a crucial part of the neonatal clinician's toolbox. Several formularies exist worldwide, but they have never been fully mapped or compared for content, structure and workflow. The objective of this review was to identify neonatal formularies, explore (dis)similarities, and raise awareness of their existence. Neonatal formularies were identified through self-acquaintance, experts and structured search. A questionnaire was sent to all identified formularies to provide details on formulary function. An original extraction tool was employed to collect DI from the formularies on the 10 most commonly used drugs in pre(term) neonates. Eight different neonatal formularies were identified worldwide (Europe, USA, Australia-New Zealand, Middle East). Six responded to the questionnaire and were compared for structure and content. Each formulary has its own workflow, monograph template and style, and update routine. Focus on certain aspects of DI also varies, as well as the type of initiative and funding. Clinicians should be aware of the various formularies available and their differences in characteristics and content to use them properly for the benefit of their patients.
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Affiliation(s)
- Dotan Shaniv
- Pharmacy Services, Kaplan Medical Center (Clalit Health Services), Pasternak St., P.O. Box 1, Rehovot 76100, Israel
- Neonatal Intensive Care Unit, Kaplan Medical Center (Clalit Health Services), Pasternak St., P.O. Box 1, Rehovot 76100, Israel
| | - Srinivas Bolisetty
- Division of Newborn Services, Royal Hospital for Women, Sydney 2031, Australia
| | - Thomas E Young
- Co-Founder of Neofax and Acorn Publishing, Raleigh, NC 27610, USA
- WakeMed Health and Hospitals, Raleigh, NC 27610, USA
- School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Barry Mangum
- Co-Founder of Neofax and Acorn Publishing, Raleigh, NC 27610, USA
- Co-Founder and CEO of Paidion Research Inc., Durham, NC 27707, USA
- School of Medicine, Duke University, Durham, NC 27710, USA
| | - Sean Ainsworth
- Directorate of Women and Children's Health, Victoria Hospital, Kirkcaldy, Scotland KY2 5AH, UK
| | - Linda Elbers
- Micromedex/NeoFax Editorial Services, Merative, 100 Phoenix Drive, Ann Arbor, MI 48108, USA
| | - Petra Schultz
- Micromedex/NeoFax Editorial Services, Merative, 100 Phoenix Drive, Ann Arbor, MI 48108, USA
| | - Melanie Cucchi
- Wolters Kluwer-Health, Clinical Effectiveness, Waltham, MA 02453, USA
| | - Saskia N de Wildt
- Department of Pharmacology and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, 3015 CN Rotterdam, The Netherlands
- Dutch Knowledge Center Pharmacotherapy for Children, Postal Box 25270, 3001 HG Rotterdam, The Netherlands
| | - Tjitske M van der Zanden
- Department of Pharmacology and Toxicology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Dutch Knowledge Center Pharmacotherapy for Children, Postal Box 25270, 3001 HG Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC Sophia Children's Hospital, 3015 CN Rotterdam, The Netherlands
| | - Neil Caldwell
- Pharmacy Department, Wirral University Teaching Hospital/Liverpool John Moores University, Arrowe Park Road, Upton, Merseyside CH49 5PE, UK
| | - Anne Smits
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Neonatal Intensive Care Unit, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium
- Department of Hospital Pharmacy, Erasmus MC, 3015 GD Rotterdam, The Netherlands
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21
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Engel E, Friedt CT, Reinert JP. An Evaluation of Tertiary Drug Resources' Consistency Regarding Drug-Drug Interactions Between Tricyclic Antidepressants and Herbal Supplements. J Pharm Technol 2023; 39:62-67. [PMID: 37051281 PMCID: PMC10084409 DOI: 10.1177/87551225231154405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Background: Tertiary drug information resources are utilized frequently by health care providers. While pharmacists are uniquely trained and prepared to interpret the information available on these resources, including the results of drug-drug interaction evaluations, discrepancies between such resources pose a major concern for clinicians with regard to patient safety and medication regimen efficacy. It was postulated that drug-drug interaction evaluations between prescription medications and over-the-counter herbal supplements would be particularly problematic. Objective: The objective of this project was to distinguish the discrepancies between tertiary drug information resources in the setting of drug-drug interactions between tricyclic antidepressants (TCAs) and herbal supplements. Methods: The following medications and herbal supplements were evaluated on Lexicomp, Micromedex, and Medscape: amitriptyline, nortriptyline, doxepin, imipramine, desipramine, amoxapine, St. John's Wort, valerian root, ginkgo biloba, and ginseng. Results: While all of the tertiary drug information resources identified a significant reaction between each TCA and St. John's Wort due to the risk of serotonin syndrome, several other discrepancies were noted, with regard to both the severity of the interaction indicated and whether or not an interaction was identified. Conclusion: It is imperative that clinicians be aware of potential discrepancies between tertiary drug information resources, including the potential for variation in both the clinical interpretation of its severity and the recognition of an interaction.
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Affiliation(s)
- Elizabeth Engel
- College of Pharmacy and Pharmaceutical
Sciences, The University of Toledo, Toledo, OH, USA
| | - Carter T. Friedt
- College of Pharmacy and Pharmaceutical
Sciences, The University of Toledo, Toledo, OH, USA
| | - Justin P. Reinert
- College of Pharmacy and Pharmaceutical
Sciences, The University of Toledo, Toledo, OH, USA
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22
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Wexler TL, Page-Wilson G. Dopamine agonists for the treatment of pituitary tumours: From ergot extracts to next generation therapies. Br J Clin Pharmacol 2023; 89:1304-1317. [PMID: 36630197 DOI: 10.1111/bcp.15660] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
Dopamine agonists are a key tool in the therapeutic arsenal of endocrinologists worldwide. They exert their effects by binding to dopamine-2 (D2) receptors expressed by pituitary tumour cells to modulate hormonal secretion and tumour size. They are the established first-line treatment for prolactinomas which express high levels of D2 receptors. Growing data support their use as an adjuvant treatment option for other pituitary tumours including growth hormone, adrenocorticotrophic hormones, thyroid hormone secreting adenomas and nonfunctional pituitary tumours, all of which have been shown to express D2 receptors as well, albeit to varying extents. For those pituitary tumours inadequately treated by dopamine agonist alone, combined agonism of D2 and somatostatin receptors represent a new frontier in clinical development. Here we review the development and role of dopamine agonist for the treatment of prolactinomas, the literature supporting their adjuvant use for the treatment of all other pituitary tumours, and recent progress in the development of the next generation of chimeric compounds that target D2 and other receptor subtypes highly expressed on pituitary tumour cells.
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Affiliation(s)
- Tamara L Wexler
- Department of Rehabilitation Medicine, NYU Grossman School of Medicine, New York, NY, USA.,Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gabrielle Page-Wilson
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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23
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Alfadly S, Anaam M, Alshammari M, Alsahali S, Ahmed E, Mubarak AB, Aldahouk A, Aljameeli M. Drug Information Sources for Patients with Chronic Conditions in the Qassim Region, Saudi Arabia. Pharmacy (Basel) 2023; 11:pharmacy11020057. [PMID: 36961035 PMCID: PMC10037653 DOI: 10.3390/pharmacy11020057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023] Open
Abstract
Appropriate drug information is vital for the correct use of drugs in pharmaceutical practice. Providing patients with educational advice on prescribed medication and on proper medication administration has become an essential part of the pharmaceutical care process. The objectives of this study were to identify patients' knowledge of prescribed medications, their desire for more information, and the sources of medication information in a population from Qassim, Saudi Arabia, using a cross-sectional descriptive study. Our target population consisted of adult patients with chronic illnesses receiving drugs at outpatient pharmacies. Nineteen pharmacies were selected based on convenience. After collecting their prescriptions, patients were asked to take part in the study by interviewers as they were leaving the pharmacies. The questionnaire used was pretested on 18 patients and then modified accordingly. questions investigated participants' knowledge of drug information, their wish for more information, and their sources of drug information, other than clinicians. Descriptive analysis was used to describe patients' physical details. The effect of sex, education, diagnosis, number of drugs, and age on knowledge of the purpose of drugs and the need for additional information were tested using Chi-square test. A total of 270 patients were interviewed, of whom 29.7% reported not knowing the purpose of at least one of their medications, and only reading a portion of the PILs. Of the patients sampled, 56.7% said they read the side effects section of the PIL, 43.3% reported reading the uses, while 27% read the contraindications. The drug -interactions section was the least read, with only 18.9% reporting reading it. A total of 57% of the patients reported that they needed more information about their medications. Highly educated patients reported using the PIL, social media, family and friends, TV, and newspapers as sources of drug information at significantly higher rates than patients with lower levels of education. Healthcare professionals should assess patient comprehension and the need for additional drug information, especially among patients with low levels of education. Additionally, healthcare professionals should consider other information sources used by their patients.
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Affiliation(s)
- Saeed Alfadly
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, P.O. Box 5888, Unaizah 51911, Qassim, Saudi Arabia
- Department of Pharmacy, College of Medicine and Health Sciences, Hadramout University, Al Mukalla P.O. Box 8892, Yemen
| | - Mohammed Anaam
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, P.O. Box 5888, Unaizah 51911, Qassim, Saudi Arabia
| | - Mohammed Alshammari
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, P.O. Box 5888, Unaizah 51911, Qassim, Saudi Arabia
| | - Saud Alsahali
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, P.O. Box 5888, Unaizah 51911, Qassim, Saudi Arabia
| | - Ejaz Ahmed
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, P.O. Box 5888, Unaizah 51911, Qassim, Saudi Arabia
| | - Abdulkareem Bin Mubarak
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, P.O. Box 5888, Unaizah 51911, Qassim, Saudi Arabia
| | - Abdullah Aldahouk
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, P.O. Box 5888, Unaizah 51911, Qassim, Saudi Arabia
| | - Muhanna Aljameeli
- Department of Pharmacy Practice, Unaizah College of Pharmacy, Qassim University, P.O. Box 5888, Unaizah 51911, Qassim, Saudi Arabia
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Mohney LA, Singh R, Feldman SR. Review of Ruxolitinib in the Treatment of Atopic Dermatitis. Ann Pharmacother 2023; 57:207-216. [PMID: 35674400 DOI: 10.1177/10600280221103282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE To review the pharmacokinetics, efficacy, and safety of a newly approved topical Janus kinase 1 (JAK) inhibitor, ruxolitinib (RUX), in patients with atopic dermatitis (AD). DATA SOURCES A literature search was completed May 1, 2022. The term RUX and AD was queried in MEDLINE (PubMed) and EMBASE databases. STUDY SELECTION AND DATA EXTRACTION Peer-reviewed articles written in English and published prior to May 1, 2022 were included. DATA SYNTHESIS In the phase II clinical trial, more patients treated with 1.5% topical RUX twice a day had a mean percentage improvement in Eczema Area and Severity Index (EASI) scores from baseline to 4 weeks, when compared to vehicle (71.6% vs 15.5%; P < 0.001). In phase III clinical trials, greater percentage of patients who received 0.75% topical RUX (TRuE-AD1 50.0% and TRuE-AD2 39.0%) or 1.5% topical RUX (TRuE-AD1 53.8% and TRuE-AD2 51.3%) achieved an Investigator's Global Assessment (IGA) score of 0 (clear) or 1 (almost clear) and had a ≥2-grade improvement from baseline to 8 weeks, when compared to vehicle (TRuE-AD1 15.1% and TRuE-AD2 7.6%; P < 0.001). RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE Atopic dermatitis is a highly prevalent long-term inflammatory skin condition. Pruritus is the main contributor of decreased quality of life in patients with AD. Topical RUX inhibits JAK1 and JAK2 producing antiinflammatory and antipruritic effects. Patients experienced a reduction in pruritus within 2 days. This decreased pruritus translated to increased quality of life and less sleep disturbances. CONCLUSION Data from phase II and III clinical trials in adult patients suggest RUX is an effective and safe therapy for AD.
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Affiliation(s)
- Lindsey A Mohney
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rohan Singh
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Department of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
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25
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Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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26
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McCloskey AP, Penson PE, Tse Y, Abdelhafiz MA, Ahmed SN, Lim EJ. Identifying and addressing pill aversion in adults without physiological-related dysphagia: A narrative review. Br J Clin Pharmacol 2022; 88:5128-5148. [PMID: 35849849 PMCID: PMC9805106 DOI: 10.1111/bcp.15463] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 01/09/2023] Open
Abstract
Solid oral dosage forms (SODFs) (often called pills by patients) are the default formulation to treat medical ailments. Beneficial therapeutic outcomes rely on patients taking them as directed. Up to 40% of the population experience difficulties swallowing SODFs, resulting in reduced adherence and impaired therapeutic efficacy. Often associated with children, this also presents in adults with dysphagia, and without any organic dysphagia (non-physiological-related or functional dysphagia). This review aims to identify and appraise current interventions used to screen for and overcome pill aversion in adults with functional dysphagia. A comprehensive search of the literature was conducted. Articles reporting pill aversion in adults aged ≥18 years with no underlying cause, history of, or existing dysphagia were included. Study quality was determined using the STROBE tool for observational studies. A narrative synthesis of the findings was prepared. We identified 18 relevant cohort studies, which demonstrate that pill aversion is a global problem. Perceived ease of and/or SODF swallowability appears to be influenced by female gender, younger age, co-morbidities (e.g., depression), and physical SODF properties. Patients often modify their medicines rather than raise this issue with their healthcare team. Screening for pill aversion is haphazard but controlled postural adjustments, coating SODFs and behavioural interventions appear to be successful solutions. SODF swallowing difficulties are a barrier to effective medication use. Healthcare professionals must recognise that pill aversion is a problem requiring identification through effective screening and resolution by training interventions, appropriate formulation selection or specialist referral.
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Affiliation(s)
- Alice P. McCloskey
- School of Pharmacy and Biomolecular SciencesLiverpool John Moores UniversityLiverpoolUK
| | - Peter E. Penson
- School of Pharmacy and Biomolecular SciencesLiverpool John Moores UniversityLiverpoolUK
| | - Yincent Tse
- Great North Children's HospitalNewcastle‐upon‐TyneUK,Newcastle University Medical SchoolNewcastle upon TyneUK
| | - Majadah A. Abdelhafiz
- School of Pharmacy and Biomolecular SciencesLiverpool John Moores UniversityLiverpoolUK
| | - Shah N. Ahmed
- School of Pharmacy and Biomolecular SciencesLiverpool John Moores UniversityLiverpoolUK
| | - Emma J. Lim
- Great North Children's HospitalNewcastle‐upon‐TyneUK,Institute of Health and SocietyNewcastle UniversityNewcastle upon TyneUK
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27
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Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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Kikuchi D, Tsuchiya M, Hatakeyama S, Tasaka Y, Uchikura T, Funakoshi R, Obara T. Actual status of patient information sharing among healthcare delivery facilities: a survey by the third subcommittee, committee on academic research, the Japanese society of hospital pharmacists. J Pharm Health Care Sci 2022; 8:30. [PMCID: PMC9636610 DOI: 10.1186/s40780-022-00260-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background Information sharing among medical professionals is important for providing quality medical care. The purpose of the present study was to elucidate the actual status of information sharing between hospitals and other healthcare delivery facilities by surveying information sharing among the pharmaceutical departments of Japanese hospitals in 2020 conducted by the Japanese Society of Hospital Pharmacists. Methods Responses were received from 3612 (43.6%) of the 8278 target medical institutions between May 2020 and August 2020. Results The proportions of hospitals that shared information with community pharmacies, other hospitals, and long-term nursing homes were 40.6%, 36.4%, and 27.3%, respectively. While tracing reports were the most common tool used by hospitals for information sharing with community pharmacies (54.3%), drug summaries were used for sharing information with other hospitals and long-term nursing homes (77.4% and 78.0%, respectively). The proportion of hospitals sharing information with community pharmacies and other hospitals showed a tendency to increase as the number of hospital beds increased. No relationship could be established between the number of hospital beds and the proportion of hospitals sharing information with long-term nursing homes. Conclusion Information between hospitals and community pharmacies was shared primarily using tracing reports, whereas information between hospitals and other hospitals and long-term nursing homes was primarily shared via drug summaries.
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Affiliation(s)
- Daisuke Kikuchi
- grid.488554.00000 0004 1772 3539Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, 983-8512 Sendai, Miyagi Japan ,Committee on Academic Research, Third Subcommittee, the Japanese Society of Hospital Pharmacists, 2-12-15, Shibuya, Shibuya-ku, 150-0002 Tokyo, Japan
| | - Masami Tsuchiya
- Committee on Academic Research, Third Subcommittee, the Japanese Society of Hospital Pharmacists, 2-12-15, Shibuya, Shibuya-ku, 150-0002 Tokyo, Japan ,grid.419939.f0000 0004 5899 0430Department of Pharmacy, Miyagi Cancer Center, 47-1 Nodayama, 981-1293 Medeshimashiote, Natori, Miyagi Japan
| | - Shiro Hatakeyama
- Committee on Academic Research, Third Subcommittee, the Japanese Society of Hospital Pharmacists, 2-12-15, Shibuya, Shibuya-ku, 150-0002 Tokyo, Japan ,grid.413006.00000 0004 7646 9307Division of Pharmacy, Yamagata University Hospital, 2-2-2 Iida-nishi, 990-9585 Yamagata-shi, Yamagata, Japan
| | - Yuichi Tasaka
- Committee on Academic Research, Third Subcommittee, the Japanese Society of Hospital Pharmacists, 2-12-15, Shibuya, Shibuya-ku, 150-0002 Tokyo, Japan ,grid.412589.30000 0004 0617 524XLaboratory of Clinical Pharmacy, School of Pharmacy, Shujitsu University, 1-6-1 Nishigawara, Naka-ku, 703-8516 Okayama, Okayama Japan
| | - Takeshi Uchikura
- Committee on Academic Research, Third Subcommittee, the Japanese Society of Hospital Pharmacists, 2-12-15, Shibuya, Shibuya-ku, 150-0002 Tokyo, Japan ,grid.410714.70000 0000 8864 3422Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, 142-8666 Tokyo, Japan
| | - Ryohkan Funakoshi
- Committee on Academic Research, Third Subcommittee, the Japanese Society of Hospital Pharmacists, 2-12-15, Shibuya, Shibuya-ku, 150-0002 Tokyo, Japan ,grid.414927.d0000 0004 0378 2140Department of Pharmacy, Kameda General Hospital, 929 Higashi-cho, 296-8602 Kamogawa-City, Chiba Japan
| | - Taku Obara
- Committee on Academic Research, Third Subcommittee, the Japanese Society of Hospital Pharmacists, 2-12-15, Shibuya, Shibuya-ku, 150-0002 Tokyo, Japan ,grid.412757.20000 0004 0641 778XDepartment of Pharmaceutical Sciences, Tohoku University Hospital, 1-1, Seriyo-machi, Aoba- ku, 980-8575 Sendai, Miyagi Japan ,grid.410829.6Division of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, 2-1, Seiryo-machi, Aoba-ku, 980-8573 Sendai, Miyagi Japan ,grid.69566.3a0000 0001 2248 6943Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, 980-8573 Sendai, Miyagi Japan
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van der Nat DJ, Huiskes VJB, Taks M, van den Bemt BJF, van Onzenoort HAW. Barriers and facilitators for the usage of a personal health record for medication reconciliation: A qualitative study among patients. Br J Clin Pharmacol 2022; 88:4751-4762. [PMID: 35584863 PMCID: PMC9796132 DOI: 10.1111/bcp.15409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 01/01/2023] Open
Abstract
AIMS Personal health records (PHRs) are more often used for medication reconciliation (MR). However, patients' adoption rate is low. We aimed to provide insight into patients' barriers and facilitators for the usage of a PHR for MR prior to an in- or outpatient visit. METHODS A qualitative study was conducted among PHR users and non-users who had a planned visit at the outpatient rheumatology department or the inpatient cardiology or neurology department. About 1 week after the hospital visit, patients were interviewed about barriers and facilitators for the usage of a PHR for MR using a semi-structured interview guide based on the theoretical domains framework. Afterwards, data were analysed following thematic analysis. RESULTS Ten PHR users and non-users were interviewed. Barriers and facilitators were classified in four domains: patient, application, process and context. We identified 14 barriers including limited (health) literacy and/or computer skills, practical and technical issues, ambiguity about who is responsible (the patient or the healthcare provider) and lack of data exchange and connectivity between applications. Besides that, ten facilitators were identified including being place and time independent, improve usability, target patients who benefit most and/or have sufficient skills, and integration of different applications. CONCLUSION Barriers and facilitators identified at the patient, application, process and context level, need to be addressed to effectively develop and implement PHRs for MR.
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Affiliation(s)
| | - Victor J. B. Huiskes
- Department of PharmacySt. MaartenskliniekNijmegenthe Netherlands,Department of Pharmacy, Radboud Institute for Health Sciences (RIHS)Radboud University Medical CentreNijmegen
| | - Margot Taks
- Department of Clinical PharmacyAmphia HospitalBredathe Netherlands
| | - Bart J. F. van den Bemt
- Department of PharmacySt. MaartenskliniekNijmegenthe Netherlands,Department of Pharmacy, Radboud Institute for Health Sciences (RIHS)Radboud University Medical CentreNijmegen,Department of Clinical Pharmacy and ToxicologyMaastricht University Medical CenterMaastricht
| | - Hein A. W. van Onzenoort
- Department of Pharmacy, Radboud Institute for Health Sciences (RIHS)Radboud University Medical CentreNijmegen,Department of Clinical Pharmacy and ToxicologyMaastricht University Medical CenterMaastricht
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Levien TL, Baker DE. Formulary Drug Reviews: Brexanolone Injection. Hosp Pharm 2022; 57:615-621. [PMID: 36081541 PMCID: PMC9445546 DOI: 10.1177/0018578719867685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
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Gill KD, Parker R. An untapped resource? Opportunities for faculty-librarian collaboration to enhance drug information resource utilization in pharmacy education. J Med Libr Assoc 2022; 110:478-484. [PMID: 37101924 PMCID: PMC10124604 DOI: 10.5195/jmla.2022.1486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
Background Doctor of pharmacy educational accreditation standards state student pharmacists should be able to evaluate the scientific literature as well as critically analyze and apply information in answering drug information questions. Student pharmacists often struggle with identifying and using appropriate resources to answer medication-related questions. To ensure educational needs were met, a college of pharmacy hired a health sciences librarian to support the faculty and students. Case Presentation The health sciences librarian collaborated with faculty and students throughout the doctor of pharmacy curriculum to identify and address any gaps related to appropriate drug resource utilization. Adding instruction time to the new student pharmacist orientation, coursework throughout the first year of the pharmacy program, and a two-semester evidence-based seminar course provided opportunities for the health sciences librarian to work with student pharmacists in the areas of library resource access, instruction on drug information resources, and evaluation of drug information found on the internet. Conclusion The deliberate inclusion of a health sciences librarian into the doctor of pharmacy curriculum can benefit faculty and students. Opportunities for collaboration are available throughout the curriculum, such as providing instruction for database utilization and supporting the research activities of both faculty and student pharmacists.
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Affiliation(s)
- Kayce D Gill
- , Health Sciences Collections Librarian, Annette and Irwin Eskind Family Biomedical Library and Learning Center, Vanderbilt University, Nashville, TN
| | - Robin Parker
- , Assistant Professor of Pharmacy Practice, Department of Pharmacy Practice, Lipscomb University College of Pharmacy, Nashville, TN
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32
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Fujii Y, Hirokawa K, Kobuke Y, Kubota T, Yoshitake T, Haraguchi K, Honda Y, Kobayashi H, Harada KH. Use of Nonprescription and Prescription Drugs and Drug Information Sources among Breastfeeding Women in Japan: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:11722. [PMID: 36141994 PMCID: PMC9517648 DOI: 10.3390/ijerph191811722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Breastfeeding women may experience various health issues that require medication. This survey aimed to gain insights into the use of nonprescription and prescription drugs by breastfeeding women in Japan. A cross-sectional study involving women with children aged under two years was conducted in Fukuoka, Japan. Nonprescription drugs were used by 26% of participants in the breastfed-only group, 41% in the breastfed more than half the time group, 55% in the formula-fed more than half the time group, and 82% in the formula-fed-only group. We found that when breastfeeding rates decreased, the use of nonprescription drugs increased (p < 0.05, Cochran-Armitage test for trend). There were significant differences in the use of nonprescription cold medicines and oral analgesics between the formula-fed and breastfed groups, but a nonsignificant difference in prescription drugs use between the groups. These results indicated breastfeeding had a significant influence on use of nonprescription drugs, which was not observed with prescription drugs. Breastfeeding women commonly used the Internet to obtain information on both nonprescription and prescription drugs; however, this did not influence medication use.
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Affiliation(s)
- Yukiko Fujii
- Department of Pharmaceutical Science, Daiichi University of Pharmacy, Fukuoka 815-8511, Japan
| | | | - Yuko Kobuke
- Department of Pharmaceutical Science, Daiichi University of Pharmacy, Fukuoka 815-8511, Japan
| | - Toshio Kubota
- Department of Pharmaceutical Science, Daiichi University of Pharmacy, Fukuoka 815-8511, Japan
| | - Taketo Yoshitake
- Department of Pharmaceutical Science, Daiichi University of Pharmacy, Fukuoka 815-8511, Japan
| | - Koichi Haraguchi
- Department of Pharmaceutical Science, Daiichi University of Pharmacy, Fukuoka 815-8511, Japan
| | - Yukiko Honda
- Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8523, Japan
| | - Hatasu Kobayashi
- Department of Environmental and Molecular Medicine, Mie University Graduate School of Medicine, Mie 514-8507, Japan
| | - Kouji H. Harada
- Department of Health and Environmental Sciences, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan
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Abstract
Purpose: Drug shortages are anticipated to worsen with time as the Coronavirus Disease 2019 (COVID-19) pandemic continues. The aim of this study is to track drug shortages within Illinois and identify causes and trends to this time-sensitive problem. Methods: In order to communicate between health systems within the state, the Illinois Council of Health-System Pharmacists (ICHP) developed a medication shortage dashboard, which collects information from health systems in the state on current drug shortages. Classes of medications inquired about included: anti-infectives, neuromuscular blocking agents (NMBAs), sedatives/analgesics, vasopressors, and "others." Data was gathered from 6 different medication shortage dashboards, ranging from May 20, 2020 to June 22, 2020 and was used to track drug shortages within Illinois. Additionally, this data was analyzed in conjunction with the number of hospital beds utilized by COVID-19 patients at the time. Results: Illinois's medication shortage dashboard tracked the supply level of 42 medications used in the treatment of patient's hospitalized with COVID-19. Data from an average of 75 health systems was analyzed each week (average response rate: 52%). For each medication, health systems identified if they had ample supply, mild shortage, moderate shortage, or critical shortage. Overall the trends of these medications positively correlated with the number of hospital beds utilized by COVID-19 patients in Illinois (r 2 = 0.7). Conclusion: The data from this study supports the conclusion that increased hospital bed utilization by COVID-19 patients is correlated with increased drug shortages of medications used in the treatment of COVID-19. It is imperative that health systems take appropriate action to prevent and manage drug shortages.
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Affiliation(s)
- Kristin Lux
- Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, IL, USA
| | - Melinda Jorns
- Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, IL, USA
| | - Carrie Vogler
- Southern Illinois University Edwardsville School of Pharmacy, Edwardsville, IL, USA
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34
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Miyazaki S. [Survey on the Provision of Drug Information by Pharmacists to Lactating Women]. YAKUGAKU ZASSHI 2022; 142:585-587. [PMID: 35650076 DOI: 10.1248/yakushi.21-00198-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many lactating women want to breastfeed their baby, but may be overly concerned regarding the drugs present in breast milk; this leads to unnecessary weaning. Moreover, lactating women may stop taking medications at their own discretion and may not receive adequate treatment. Therefore, pharmacists are required to provide appropriate information to lactating women. In 2020, we conducted a questionnaire survey on 1781 pharmacists with the aim of investigating the actual situation of the provision of drug information by pharmacists to lactating women. The results showed that the information source that pharmacists place more importance on is the package itself, rather than databases and books, which are considered to be appropriate sources of information on the use of medicines by lactating women. Besides, more than 90% of pharmacists answered that they would like to participate in the study session. These results indicate that it is important to set up information sources that can effectively be used at workplaces and to organize study sessions for pharmacists with the support of National Center of Child Health and Development and other bodies. By improving the environment, with the aim of further improving the level of pharmacists, pharmacists will be able to provide accurate information more appropriately.
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Affiliation(s)
- Seiko Miyazaki
- Social Pharmacy and Regulatory Science, Showa Pharmaceutical University
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35
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Cole KA, Zhou AY, Jones T, Moore WJ, Chandler EL, Zafonte VB, Morrisette T, Gauthier TP, Kisgen J, Barner A, Johnson MD, Tagare RD, Justo JA. How to Harness the Power of Social Media for Quality Drug Information in Infectious Diseases: Perspectives on Behalf of the Society of Infectious Diseases Pharmacists. Clin Infect Dis 2022; 74:e23-e33. [PMID: 35568481 PMCID: PMC9384058 DOI: 10.1093/cid/ciac081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Indexed: 02/06/2023] Open
Abstract
Clinicians, researchers, and the public frequently turn to digital channels and social media for up-to-the-minute information on novel therapeutics and vaccines. The value of credible infectious diseases drug information is more apparent in the setting of the coronavirus disease 2019 (COVID-19) pandemic. This viewpoint by the Society of Infectious Diseases Pharmacists (SIDP) provides guidance on utilizing social media platforms to optimize infectious diseases pharmacotherapy. It includes tips for all levels of users but primarily serves a guide for the infectious diseases clinician who has not yet joined social media. It compares various social media platforms and suggests which to begin with based on user needs, recommends efficient curation of social media content, and outlines a stepwise approach (shown below) to increasing engagement over time. This summary will hopefully spur further quality content and engagement regarding drug information from the infectious diseases social media network.
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Affiliation(s)
- Kelli A Cole
- Medical Science Liaison, OH/MI/W. PA, ViiV Healthcare, Research Triangle Park, North Carolina, USA
| | - Anna Y Zhou
- Department of Pharmacy, Loma Linda University Health, Loma Linda, California, USA
| | - Travis Jones
- Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
| | - W Justin Moore
- Department of Pharmacy, Northwestern Medicine, Chicago, Illinois, USA
| | | | - Veronica B Zafonte
- Department of Pharmacy, Jamaica Hospital Medical Center, Richmond Hill, New York, USA
| | - Taylor Morrisette
- Department of Clinical Pharmacy and Outcomes Sciences, Medical University of South Carolina College of Pharmacy, Charleston, South Carolina, USA.,Department of Pharmacy Services, Medical University of South Carolina Shawn Jenkins Children's Hospital, Charleston, South Carolina, USA
| | - Timothy P Gauthier
- Clinical Pharmacy Enterprise, Baptist Health South Florida, Miami, Florida, USA
| | - Jamie Kisgen
- Department of Pharmacy, Sarasota Memorial Health Care System, Sarasota, Florida, USA
| | - Amanda Barner
- Department of Pharmacy, Cambridge Health Alliance, Cambridge, Massachusetts, USA
| | - Melissa D Johnson
- Division of Infectious Diseases & International Health, Duke University Medical Center, Durham, North Carolina, USA
| | - R Dawn Tagare
- Department of Pharmacy, University of Utah Health, Salt Lake City, Utah, USA
| | - Julie Ann Justo
- Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina College of Pharmacy, Columbia, South Carolina, USA
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36
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Young N, Tokumaru S, Goo R. Training Future Pharmacists to Optimize the Healthcare Workforce. Hawaii J Health Soc Welf 2022; 81:28-30. [PMID: 35495074 PMCID: PMC9036450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Many efforts are taking place to improve the quality of healthcare and reduce healthcare cost. Pharmacists play a key role in optimizing the healthcare workforce, and colleges of pharmacy are adapting to this need by emphasizing skills needed to improve quality health measures, interprofessional collaboration and communication, and supplying quality drug information. The University of Hawai'i at Hilo Daniel K. Inouye College of Pharmacy has incorporated additional pharmacy practice experience electives to teach pharmacy students to analyze and optimize workflow, identify high-risk patients in need of intervention, and work collaboratively with providers to decrease patient burden. The pharmacy curriculum has also increased the number of interprofessional educational events for enhancing interprofessional collaboration and communication, including in a telehealth setting. Furthermore, the college of pharmacy has increased the number of drug information assignments and practical exams to increase competency and the speed of providing quality, evidence-based drug information to providers. This article presents on overview of the health care workforce needs and examples of the increased efforts to train future pharmacists in Hawai'i to improve healthcare access and quality of patient care, as well as decrease healthcare costs.
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Affiliation(s)
- Nicole Young
- Department of Pharmacy Practice, The Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo; Hilo, HI
| | - Sheri Tokumaru
- Department of Pharmacy Practice, The Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo; Hilo, HI
| | - Roy Goo
- Department of Pharmacy Practice, The Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo; Hilo, HI
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Kontsioti E, Maskell S, Bensalem A, Dutta B, Pirmohamed M. Similarity and Consistency Assessment of Three Major Online Drug-Drug Interaction Resources. Br J Clin Pharmacol 2022; 88:4067-4079. [PMID: 35362214 PMCID: PMC9545693 DOI: 10.1111/bcp.15341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022] Open
Abstract
AIM To explore the level of agreement on drug-drug interaction (DDI) information listed in three major online drug information resources (DIRs) in terms of: (1) interacting drug pairs; (2) severity rating; (3) evidence rating and (4) clinical management recommendations. METHODS We extracted information from the British National Formulary (BNF), Thesaurus, and Micromedex. Following drug name normalisation, we estimated the overlap of the DIRs in terms of DDI. We annotated clinical management recommendations either manually, where possible, or through application of a machine learning algorithm. RESULTS The DIRs contained 51,481 (BNF), 38,037 (Thesaurus), and 65,446 (Micromedex) drug pairs involved in DDIs. The number of common DDIs across the three DIRs was 6,970 (13.54% of BNF, 18.32% of Thesaurus, and 10.65% of Micromedex). Micromedex and Thesaurus overall showed higher levels of similarity in their severity ratings, while the BNF agreed more with Micromedex on the critical severity ratings and with Thesaurus on the least significant ones. Evidence rating agreement between BNF and Micromedex was generally poor. Variation in clinical management recommendations was also identified, with some categories (i.e. Monitor and Adjust dose) showing higher levels of agreement compared to others (i.e. Use with caution, Wash-out, Modify administration). CONCLUSIONS There is considerable variation in the DDIs included in the examined DIRs, together with variability in categorisation of severity and clinical advice given. DDIs labelled as critical were more likely to appear in multiple DIRs. Such variability in information could have deleterious consequences for patient safety, and there is a need for harmonisation and standardisation.
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Affiliation(s)
- Elpida Kontsioti
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool, United Kingdom.,Institute for Risk and Uncertainty, University of Liverpool, Liverpool, United Kingdom
| | - Simon Maskell
- Department of Electrical Engineering and Electronics, University of Liverpool, Liverpool, United Kingdom
| | | | - Bhaskar Dutta
- Patient Safety Center of Excellence, AstraZeneca, Gaithersburg, MD, United States
| | - Munir Pirmohamed
- The Wolfson Centre for Personalized Medicine, MRC Centre for Drug Safety Science, Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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38
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Afanasjeva J, Gabay M, Poznanski T, Kerns S. Transdermal Patch Administration and Magnetic Resonance Imaging (MRI)-2020. Hosp Pharm 2022; 57:117-120. [PMID: 35521021 PMCID: PMC9065518 DOI: 10.1177/0018578720987138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This is an update to the 2010 article published in Hospital Pharmacy on safety concerns involving transdermal patches and magnetic resonance imaging (MRI). Since publication of the original article, new brand and generic transdermal medications have become available and notable changes regarding the presence or absence of metallic content among existing transdermal formulations occurred. To update the tables within the article, Food and Drug Administration (FDA)-approved transdermal medications through October 2020 were researched in order to determine metallic content and procedures for reapplication after MRI, if applicable. Readers should consult the prescribing information or manufacturer for the most current information on use of transdermal medications in the MRI setting. Of note, manufacturers have not evaluated the use of transdermal products while patients undergo a MRI scan.
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Affiliation(s)
| | - Michael Gabay
- University of Illinois at Chicago, Chicago, IL, USA,Michael Gabay, University of Illinois at Chicago College of Pharmacy, 833 S Wood Street, Chicago, IL 60612, USA.
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Clinard V, Stebbins M, Lynch S. The Evolution of Drug Information Services to Asynchronous Delivery of Pharmacist eConsults. J Pharm Technol 2021; 37:316-319. [PMID: 34790970 DOI: 10.1177/87551225211049470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Drug information (DI) services provided an avenue to expand the role of pharmacists as the medication experts. The focus of DI has shifted from general questions submitted to DI centers to patient-specific questions that optimize care. One method to increase access to pharmacist expertise is through pharmacy eConsults. Pharmacy eConsults provide specialist care for medically complex patients using a patient-centered, asynchronous approach. The purpose of this article is to describe the evolution of consults from formal drug information services and describe one academic medical center's implementation of a pharmacy eConsult service to provide patient-specific DI.
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40
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Lang A, Veronin MA, Reinert JP. A Comparison of Tertiary Drug Resources' Consistency Regarding Drug-Drug Interactions of Adjunctive Analgesics. J Pharm Technol 2021; 37:12-16. [PMID: 34752561 DOI: 10.1177/8755122520951331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Health care providers routinely rely on tertiary drug information resources to affirm knowledge or proactively verify the safety and efficacy of medications. Though all patient care areas are affected, the reliability of these resources is perhaps nowhere as poignant as it is in high-acuity settings, including the emergency department and the intensive care unit. As providers seek to identify adjunctive analgesics for acute pain in these areas, they must be able to rely on the integrity to whichever resource their institution has granted access. Objective: To determine the congruency of drug-drug interaction information found on 3 tertiary drug resources. Methods: A drug-drug interaction analysis was conducted on Micromedex, Lexicomp, and Medscape. Adjunctive analgesics included dexmedetomidine and ketamine, which were compared with the intravenous opioid products morphine, fentanyl, and hydromorphone. Results: Significant discrepancies were appreciated with regard to the severity of drug-drug interactions. In addition, the heterogeneity in which reaction severity and likelihood are described by each respective resource makes direct comparisons difficult. Interaction warnings for dexmedetomidine and fentanyl included a "major interaction" from Micromedex, whereas Lexicomp did not identify a risk and Medscape only recommended increased monitoring on the grounds of respiratory and central nervous system depression. Conclusions: Health care providers must remain vigilant when reviewing tertiary drug information resources. Pharmacists possess the training and skills necessary to assist interdisciplinary medical teams in providing optimal patient care through evaluating and applying the information gleaned from these resources.
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Veronin MA, Lang A, Reinert JP. Remdesivir and Coronavirus Disease 2019 (COVID-19): Essential Questions and Answers for Pharmacists and Pharmacy Technicians. J Pharm Technol 2021; 37:62-74. [PMID: 34752546 DOI: 10.1177/8755122520967634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective: To conduct a review of the investigational drug remdesivir and its therapeutic potential for treatment of COVID-19, in the form of a series of questions and answers. The purpose of the review is to narrow gaps in knowledge, clarify concepts, and to investigate research advancements for health care professionals. Data Sources: From June 2020 to August 2020, we conducted comprehensive searches of MEDLINE-PubMed, Scopus, and Google Scholar databases with no time limitations. Search terms were included that contained the terms "remdesivir," "COVID-19," "novel coronavirus" and "evidence," "therapy," "safety," "effectiveness," "efficacy," "clinical trial." Study Selection and Data Extraction: The sources of information include all publicly available data from previously published research reports. Reports must have at least one reference to remdesivir as a treatment modality for COVID-19 with no specified outcomes. Data Synthesis: Major research findings on the efficacy and safety of remdesivir are summarized in tabular format and presented in chronological order. Results of this review reveal remdesivir to be an effective therapy in specific clinical contexts; however, in several areas, available data are insufficient to support evidence-based guidance for remdesivir in the treatment of COVID-19. Conclusions: Clinical trials on remdesivir are ongoing, yet questions remain and further research is needed as to the selection of patients, effectiveness, and duration of treatment in the use of remdesivir for treatment of COVID-19.
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Beauchene JK, Levien TL. Lasmiditan: Acute Migraine Treatment Without Vasoconstriction. A Review. J Pharm Technol 2021; 37:244-253. [PMID: 34752575 DOI: 10.1177/87551225211024630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To review the efficacy and safety of the newly Food and Drug Administration approved drug lasmiditan, and its place in therapy in the treatment of acute migraine attacks. Data Sources: A literature search of Web of Science, PubMed, and Google Scholar was preformed (September 1999 to May 2021) using the following search terms: acute migraine treatment, triptans, lasmiditan, Reyvow, Rimegepant, Nurtec, Ubrogepant, Ubrelvy, migraine, vasoconstriction, and cardiovascular risk. Product labeling, https://www.clinicaltriasl.gov, and product monographs were also reviewed. Study Selection and Data Extraction: Relevant English-language studies were considered. Data Synthesis: Lasmiditan is the first in its class approved for acute migraine treatment. Lasmiditan exerts its therapeutic effect through agonism at the 5-HT1F receptor, which has been shown to produce no vasoconstriction in preclinical models. Relevance to Patient Care and Clinical Practice: It is both scientifically and clinically relevant to review lasmiditan and determine the value of an acute migraine drug that does not induce vasoconstriction. Patients with preexisting cardiovascular conditions for which current migraine therapy is contraindicated may benefit from therapeutic use of lasmiditan. However, the potential cardiovascular benefit needs to be weighed against the increased central nervous system risks observed with lasmiditan. Conclusions: Lasmiditan is an oral tablet drug that is used for acute migraine abortive treatment and data suggest that it does not induce vasoconstriction, a common side effect often observed with the current first-line abortive migraine treatment drug class, triptans. This is especially important in acute migraine patients with cardiovascular risk factors in which triptan use is contraindicated.
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Nguyen C. The Drug Manufacturer as a Drug Information Resource. J Pharm Technol 2021; 37:161-164. [PMID: 34752570 DOI: 10.1177/87551225211005427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Pharmacists use a myriad of drug resources for patient care; however, the drug manufacturer is often overlooked and underutilized as a resource for drug information. Pharmaceutical companies have a medical information department that is responsible for providing drug information to pharmacists and the public about the company's products. This article will explain the purpose and functions of the medical information department within a pharmaceutical company. In addition, the type of information that may be requested and the ways to request drug information will be discussed.
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Gabay M. RxLegal: The Evolving Legal Landscape of Telehealth. Hosp Pharm 2021; 56:633-634. [PMID: 34732913 DOI: 10.1177/0018578720965428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The provision of telehealth services has increased dramatically during the COVID-19 pandemic with the introduction of various temporary waivers and rules designed to increase flexibility in the pandemic response. This expansion of telehealth has not only increased patient access, but protected essential healthcare workers from potential virus exposure. The advantages of increased telehealth services has prompted the introduction of a bipartisan bill in Congress, which seeks to make some of the temporary measures undertaken during the pandemic permanent. Pharmacists have been able to expand telehealth services further with the implementation of these regulatory changes.
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Wallskog KE, Lauderdale S, Peppard WJ, Kirkwood C, Taylor S, Johnston S. Inpatient Perioperative Formulary Restriction of Intravenous Acetaminophen at Vizient Partner Hospitals: A National Survey of Pharmacists. Hosp Pharm 2021; 56:650-659. [PMID: 34732917 DOI: 10.1177/0018578720931751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: Despite potential benefits of intravenous (i.v.) administration of acetaminophen (APAP), consistent outcome data are lacking. This, combined with the higher acquisition cost of the drug, has led to variation in i.v. APAP management strategies. This project evaluated the contemporary formulary status and restrictions of i.v. APAP in the perioperative setting. Methods: A survey focusing on i.v. APAP formulary restriction in the perioperative setting was developed by the Vizient Pharmacy Research Committee and distributed to Vizient Pharmacy Program participant listservs for Pharmacy Directors or Drug Information Pharmacists. The four survey domains included hospital characteristics, perioperative i.v. APAP formulary status and prescribing restrictions, perioperative i.v. APAP use, and perioperative i.v. APAP medication use evaluation (MUE) results. Responses were collected and summarized, and primary outcomes were evaluated using Fisher's exact test. Results: A total of 1195 surveys were distributed with a response rate of 19%. Respondents were equally distributed between academic medical centers (AMC) and non-academic medical centers (non-AMC). Two cohorts were examined: those with i.v. APAP on formulary and those without. The non-AMCs showed a larger proportion of hospitals with the medication on formulary (P = .041). Regarding formulary decision-making, the AMCs were more considerate of value. Several different practices were employed to limit or restrict i.v. APAP. Conclusion: A survey of directors of pharmacy and drug information specialists revealed that the majority of hospitals have i.v. APAP on formulary for perioperative use, but use is restricted. Differences in i.v. APAP formulary practices between AMCs and non-AMCs warrant further consideration.
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Affiliation(s)
| | | | | | | | - Stacy Taylor
- College of Pharmacy, University of Kentucky, Lexington, KY, USA
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Ferrill MJ, FakhriRavari A, Hong L, Wedret JJ. A Focus on Evaluating Major Study Limitations in Order to Apply Clinical Trials to Patient Care: Implications for the Healthcare Team. Hosp Pharm 2021; 56:597-603. [PMID: 34720166 DOI: 10.1177/0018578720931750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: With more than a million new biomedical articles published annually, healthcare providers must stay up to date in order to provide optimal evidence-based patient care. The concise ROOTs (relevance, observe validity, obtain clinically significant results, and translate results to clinical practice) format is a valuable tool to assist with literature evaluation. Purpose: To illustrate how major study limitations found in clinical trials might inhibit the ability to adopt the findings of such studies to patient care. Methods: Examples from published clinical trials that contain major study flaws were used to illustrate, if taken at face value, would lead to erroneous assumptions, and if adopted, could potentiallly harm patients. Conclusion: When evaluating the literature, it is crucial to identify limitations in the published literature that might reduce the internal validity, affect the results, or limit the external validity of clinical trials, hence affecting the usability of literature for patient care. This article provides examples of clinical trials that contain major study limitations with potentially erroneous assumptions. These illustrations are meant to show how important it is to delve deeper into an article before conclusions are drawn.
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Affiliation(s)
| | | | - Lisa Hong
- Loma Linda University, Loma Linda, CA, USA
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Capiau A, Mehuys E, Dhondt E, De Backer T, Boussery K. Physicians' and pharmacists' views and experiences regarding use of direct oral anticoagulants in clinical practice. Br J Clin Pharmacol 2021; 88:1856-1865. [PMID: 34625983 DOI: 10.1111/bcp.15106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 09/16/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022] Open
Abstract
AIM Direct oral anticoagulants (DOACs) are increasingly used compared to vitamin K antagonists (VKAs). Guidelines advocate a structured multidisciplinary approach in the management of patients treated with DOACs. The aim of this study was to assess the views and experiences of physicians and pharmacists regarding DOAC use in clinical practice. METHODS An online questionnaire was sent to both primary (general practitioners [GPs], community pharmacists) and secondary healthcare professionals (cardiologists, residents in internal medicine and hospital pharmacists) between March and July 2020. The questionnaire covered four topics: (i) current practice, (ii) prescribing behaviour (only for physicians), (iii) self-perceived knowledge about DOACs and (iv) views and opinions about DOACs versus VKAs. RESULTS In total, 110 physicians and 111 pharmacists completed the survey. Healthcare professionals in secondary care had more experience with DOACs and felt more confident with higher self-perceived knowledge about DOACs compared to their colleagues in primary care. Healthcare professionals' self-perceived knowledge was more or less complementary, for example physicians felt less confident in managing drug-drug interactions (DDIs) where pharmacists reported being more confident in this topic. Physicians reported uncertainties on the potential impact of risk factors - such as older age, lower body weight and DDIs - on appropriate DOAC dosing. CONCLUSION Complementarity in physicians' and pharmacists' self-perceived knowledge levels of DOACs may facilitate and necessitate future multidisciplinary collaboration initiatives for the management and follow-up of DOAC patients.
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Affiliation(s)
- Andreas Capiau
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Els Mehuys
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Eline Dhondt
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Tine De Backer
- Department of Cardiology, Heart Centre, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Koen Boussery
- Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Nguyen C. The accuracy and completeness of drug information in Google snippet blocks. J Med Libr Assoc 2021; 109:613-617. [PMID: 34858091 PMCID: PMC8608169 DOI: 10.5195/jmla.2021.1229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introduction: Consumers commonly use the Internet for immediate drug information. In 2014, Google introduced the snippet block to programmatically search available websites to answer a question entered into the search engine without the need for the user to enter any websites. This study compared the accuracy and completeness of drug information found in Google snippet blocks to US Food and Drug Administration (FDA) medication guides. Methods: Ten outpatient drugs were selected from the 2018 Clinical Drugstats Database Medical Expenditure Panel Survey. Six questions in the medication guide for each drug were entered into the Google search engine to find the snippet block. The accuracy and completeness of drug information in the Google snippet block were quantified by two different pharmacists using a scoring system of 1 (less than 25% accurate/complete information) to 5 (100% accurate/complete information). Descriptive statistics were used to summarize the scores. Results: For five out of the six questions, the information in the Google snippets had less than 50% accuracy and completeness compared to the medication guides. The average accuracy and completeness scores of the Google snippets were highest for “What are the ingredients of [the drug]?” with scores of 3.38 (51–75%) and 3.00 (51–75%), respectively. The question on “How to take [drug]?” had the lowest score with averages of 1.00 (<25%) for both accuracy and completeness. Conclusion: Google snippets provide inaccurate and incomplete drug information when compared to FDA-approved drug medication guides. This aspect may cause patient harm; therefore, it is imperative for health care and health information professionals to provide reliable drug resources to patients and consumers if written information may be needed.
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Affiliation(s)
- Cambrey Nguyen
- , Clinical Assistant Professor, Drug Information, Pharmacy Practice, University of Kansas School of Pharmacy, Lawrence, KS
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Jones EP, Wisniewski CS. Video killed the multiple-choice quiz: capturing pharmacy students' literature searching skills using a screencast video assignment. J Med Libr Assoc 2021; 109:672-676. [PMID: 34858100 PMCID: PMC8608213 DOI: 10.5195/jmla.2021.1270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: In a flipped, required first-year drug information course, students were taught the systematic approach to answering drug information questions, commonly utilized resources, and literature searching. As co-coordinator, a librarian taught three weeks of the course focused on mobile applications, development of literature searching skills, and practicing in PubMed. Course assignments were redesigned in 2019 based on assessment best practices and replaced weekly multiple-choice quizzes used in prior iterations of the course. Case Presentation: Following two weeks of literature searching instruction, students were assigned a drug information question that would serve as the impetus for the search they conducted. Students (n=66) had one week to practice and record a screencast video of their search in PubMed. Students narrated their video with an explanation of the actions being performed and were assessed using a twenty-point rubric created by the course coordinator and librarian. The librarian also created general feedback videos for each question by recording screencasts while performing the literature searches and clarifying troublesome aspects for students. The librarian spent about twenty-four hours grading and six hours writing scripts, recording, and editing feedback videos. Conclusion: Most students performed well on the assignment and few experienced technical difficulties. Instructors will use this assignment and feedback method in the future. Screencast videos proved an innovative way to assess student knowledge and to provide feedback on literature searching assignments. This method is transferrable to any medical education setting and could be used across all health professions to improve information literacy skills.
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Affiliation(s)
- Emily P Jones
- , Health Sciences Librarian, Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Christopher S Wisniewski
- , Professor, Department of Clinical Pharmacy and Outcome Sciences, Medical University of South Carolina, Charleston, SC
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Leceta A, García A, Sologuren A, Campo C. Bilastine 10 and 20 mg in paediatric and adult patients: an updated practical approach to treatment decisions. Drugs Context 2021; 10:dic-2021-5-1. [PMID: 34457015 PMCID: PMC8366504 DOI: 10.7573/dic.2021-5-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/02/2021] [Indexed: 01/03/2023] Open
Abstract
Background Bilastine, a non-sedating H1-antihistamine, is indicated to treat the symptoms of allergic disorders (e.g. rhinoconjunctivitis and urticaria) in adults and adolescents and, more recently, in children. Following its marketing approval, many questions regarding the ideal use of bilastine in various clinical practice situations have been received by the Medical Information Department (MID) of Faes Farma Spain. This article is an update of a previous review, with a focus on recent clinical information on the use of bilastine in paediatric and other populations. Methods Results of recent clinical studies in paediatric and other populations as well as questions received and responses provided by the Faes Farma MID. Results The information regarding the use of bilastine in paediatric patients is the most relevant aspect of this updated review. The stepwise approval of the paediatric formulations in various countries started with the European Medicines Agency approval in 2017 in accordance with a 2009 Paediatric Investigation Plan, followed by approval in other countries. The queries that are most commonly received by the Faes Farma MID include the potential for drug interactions involving bilastine and other frequently used drugs, and the use of bilastine in special populations or to treat specific symptoms related to allergic conditions. As the concomitant use of many medications is not permitted during clinical trials, the advice provided regarding the concomitant use of other medications with bilastine considers the pharmacological properties of both the drug in question and bilastine, as well as expert opinion. Likewise, advice regarding the use of bilastine in special populations (e.g. patients with renal impairment, obesity, lactose intolerance, and elderly or pregnant individuals) or to treat specific symptoms (e.g. treatment-resistant urticaria, pruritus or BASCULE syndrome) considers the best evidence from a variety of sources, including clinical studies, real-world experience, guideline recommendations and expert opinion. Conclusion This updated review provides current data regarding the best use of bilastine in specific situations and patients and identifies areas in which further knowledge is required. Although decisions regarding the use of bilastine may be aided by expert opinion that relies on knowledge of the underlying science, additional research and evidence are required to answer certain queries regarding the use of bilastine.
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Affiliation(s)
- Amalia Leceta
- Medical Affairs Department, Faes Farma SA, Bizkaia, Spain
| | | | | | - Cristina Campo
- Head of Clinical Research Medical Affairs Department, Faes Farma SA, Bizkaia, Spain
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